DYING TO LIVE

Indirect compensation among ideas to increase donation

Authorities are finding new ways to encourage organ donation, including indirectly compensating donors and families.

Charles H. Patrick, director of the Alabama Organ Center, said 11 states have passed laws granting state income tax deductions to cover some costs of donating organs - usually a kidney, bone marrow or part of a pancreas, intestine or lung. These costs can mount for a living donor.

Although it is illegal to directly pay for organs, other proposals would give $300 to the family of a deceased donor for funeral expenses.

Changing laws could increase donation rates, too, he said. About 1.3 million people in Alabama have indicated on the backs of their driver's licenses that they want to be organ donors, Patrick said.

Sometimes first-person consent is overridden by families after potential donors die. Legally, the Alabama Organ Center has a right to the organs, but it's not going to fight families for them, Patrick said.

This problem could be solved by a federal law mandating that first-person consent for donating organs is binding; if somebody decides to be an organ donor, those wishes must be carried out. That would take the decision out of the hands of families and organ centers, Patrick said. Already, 10 states have implemented this policy on their own, he said.

Patrick said public education campaigns have helped increase donation rates. When he entered the field 30 years ago, only about 30 percent of families agreed to donate organs of a dead relative. That rate is now up to 50 percent, and officials want to increase it to 75 percent.

Dr. Devin Eckhoff, head of transplantation at UAB, said increasing numbers of people are donating organs while they are alive. The most dramatic impact has been for kidney transplants. Last year, UAB transplanted 258 kidneys, and 173 came from living donors.

Eckhoff said the trend is moving toward liver transplants, although there are greater concerns about risks for living donors. Some transplant centers already are taking portions of livers from living donors and transplanting them in patients.

UAB's liver transplant program will likely move in that direction, Eckhoff said.

"I think long term it will be part of the program," he said. "I think we have an obligation to all the potential donors to push the limits of marginal donors, to get organ donation up in the state."